Tag Archives: Health

This week marks the five year anniversary of starting the Bi[polar] Curious Blog and for many reasons I have decided that this post will also conclude my time posting here. That might sound abrupt to some people, though most blogs seem to fizzle out rather than actually “end”. I’ve actually been considering the notion of stopping here for about 8 weeks and a number of things convinced me to make this move.

First, I’ve met my goals.

I started the Bi[polar] Curious Blog when I just started working toward understanding my own mental health, where I fit in the overall umbrella of mental illness and what it meant to me. I knew from many situations that I was doing a poor job at communicating about my symptoms and experiences and I hoped blogging would help me sort that out. On top of that, I was tired of the strange sense of shame having to hide these questions provoked and I was tired of people mistranslating my symptoms of mental illness into problems that they weren’t (things like addiction, unbridled selfishness, or generally being an asshole -to name a few). I wanted understanding for myself, but I wanted to help other people I know understand too. Finally, it was important to me not to give up on the blog impulsively, I wanted to really push myself to stick with it even when it was difficult.

In terms of understanding bipolar disorder I feel like I’ve come a really long way in the last five years. I’ve reached the point where I can separate my symptoms from my typical behavior and identify what each of them means. I know that my symptoms are atypical because of my treatment resistance and mega-ultra-intense cycling but I also know that each person living with mental illness is an individual with symptoms that vary from person to person. The diagnoses we live with are there to help us receive treatment and to communicate about our illnesses, but ultimately we’re all unique and need to seek treatment based on our own individual needs. I also believe that having bipolar disorder has nothing to do with my personality and that finding myself burdened with symptoms like agitation, hostility, or even homicidal thoughts do not make me a bad person, or someone to be feared. On the contrary, the way in which I’ve worked against these symptoms is a perfect example of how I’ve taken responsibility for my illness and am constantly striving to react to my symptoms in a healthy and safe way.

When it comes to communicating I feel like I’ve learned a lot from writing about my experiences, but also from the strangeness that came from having strangers or friends or family repeat many of the things back to me that I had written. I’ve come from being unable to clearly communicate about my symptoms to communicating in a support group and therapy, then to lead a support group and to talk openly to friends, family, and then finally in public about my illness (in addition to writing about those experiences here). Being open has directed me to a place where I don’t feel ashamed about my experiences or symptoms, and I don’t feel ashamed to communicate them with others anymore. Writing has been one of the ways I have been able to find the words to use, and I’ve been thrilled to find that I can communicate about my experiences well enough now for others to be able to relate.

I’ve stuck with the blog for 5 years. Five years! Frankly that really exceeds the expectations I had, I thought I’d be lucky if I lasted a year. Even though there were times when I couldn’t post because I was too ill, I am happy that I never abandoned the blog impulsively. In all that time I know I’ve helped others understand because they’ve told me so, from strangers to friends to family.

Second, I feel that I’ve started to outgrow this blog.

When I started writing I had close to zero support regarding managing my bipolar symptoms and I was doing so by trying my best to constantly control everything around me. You can imagine how well that worked! I was exhausted all the time and desperate for help, and I wanted this blog to chronicle what it was like trying to find that help along the way.

This month I’m graduating from the DBT (Dialectical Behavioral Therapy) program I’m in and even though my symptoms are still treatment resistant and I don’t have any help from traditional psychiatric medication to help with them I’ve learned how to set myself up to handle things better when they occur and how to cope when I’m reacting poorly. I’m not a wizard at it, but I am practicing what I need to do and I’ve already seen an improvement in my quality of life.

You can bet that after five years of writing about one area of my life I’m a little sparse on topics -especially since things have stabilized for me a little. I’m finding that being stable doesn’t mean everything is kittens and rainbows, actually it means having to deal with many other issues I’ve ignored in the process of working on figuring out the bipolar-disorder-thing. Yes, there are plenty of other things I’m working on (things like detaching myself from codependency habits, creating healthy boundaries with my friends and family, and addressing the matter of my sexuality and feelings of self-worth) but GUESS WHAT? None of those are bipolar disorder! I want to give my mind the freedom and space to consider these other problems without having to continuously go back to bipolar disorder, and at this point that is partially what this blog has become for me.

Third (and finally), I’m at peace with having a mental illness.

It took me many, many years to reach the point where I could accept that I would be living with mental illness for the rest of my life and honestly it was tough sometimes to make strides toward accepting that just because that is true doesn’t mean my life isn’t worth living. When medication after medication failed to work for me I saw a lot of hopeless days but I’ve finally reached the point where I can say with all honesty that I can’t change this. I can’t control my symptoms or urges, but I’m doing the best I can to cope with them in a healthy way.

Whatever fear I was wrestling with, whatever doubt and denial I was struggling with is gone. I finally feel a sense of peace about it, and even though that doesn’t change the fact that I have a mental illness it means I don’t need to worry about it every minute of every day anymore.

The struggle with coming to terms with this is over, and without that struggle there is no blog to write.

Thank you so much for all of your support!

I’ve really valued everyone who read this blog and left comments and I know that wont end today. It should be noted that the Mental Health Bloggers on WordPress are all total rockstars and I learned countless things from reading their/your work. I’d urge anyone who wants to share a link to their blog in the comments to do so, like I said I’ll be leaving things up here but if anyone is looking for something to read with fresh content there are tons of exceptionally good blogs to try.

Thank you for going through this with me. Thank you for inspiring me to write more, and inspiring me to create good writing habits. Thank you readers for keeping an open mind. Thank you writers for reminding us we’re not alone.

For many years now I’ve been avoiding my gut instincts. Maybe avoiding is the wrong word, I’ve been wary of them and I haven’t been implementing them when they come up. I guess that is probably one definition of avoiding, but for whatever reason it feels important to me to add that part about feeling wary.

I’ve been thinking of my gut feelings as the product of an inner-office anonymous comments box and I’m the poor sap who has to sift through the comments that have been left there.

“This is a place to leave comments,” the box says, “ideas, and suggestions on how to make the office run more smoothly. They will be reviewed by management in the consciousness department.”

Of course, I haven’t been able to take the program very seriously when many of the comments have read things like:

Absolutely trust that guy who is inviting you inside his house and says there is free taco bell inside.

or

Can we please collect more roadkill? The IT department won’t even notice the smell.

or

Make Fridays “casual werewolf” day.

In the beginning I followed through with most of the suggestions in the box only to realize there are one or two A-holes in the office (damn you Psychosis! Mania! And don’t think I don’t see you sneaking around over there too Depression!) who keep leaving these bizarre notes they expect me to follow through on.

Without a filter to keep the odd comments from the important ones the results historically turned out poorly.

But that’s always the story, isn’t it? One or two bad apples ruining it for everyone. As the manager of the office inside my brain I’ve had to stop allowing comments from within myself simply to keep from doing some totally stupid and irrational things. The trouble is… all of the good, useful comments have also been discarded in the process.

In the meantime I’ve worked to try to improve the comments program. It has been temping every time someone has told me “just trust your gut” I feel like I ought to give it a second chance, despite constantly winding up in situations where I’ve taken away all of the pairs of scissors and staplers in the office during a busy week or deprived my employees of contact with the outside world for days until they go on strike and say, “you know, we really aren’t getting any work done at this rate.”

As someone who wants to manage this office well I’ve taken it upon myself to try to find answers. To research and test through trial and error what I could do to keep the team running. I’ve scoured the anonymous comments with handwriting analysis in hopes of being able to pull Psychosis’ notes from the rest (and the rest of those who love to throw a wrench into things) with no luck. I even hired on a new employee (Rationalization) to help manage the comments department but ultimately it didn’t seem to make much difference. Before long Rationalization seemed willing to justify why casual-werewolf-Fridays would be great and I had to halt the project over again.

While I was searching for a solution I wasn’t expecting things to get worse. One of my employees, Sexuality, began leaving notes in the comment box in an effort to make the break-room more LGBT friendly. I discarded all of those comments with the suspicion that they may have come from Psychosis playing a prank. Denying all of the comments meant denying the legitimate ones too, and before long Sexuality was upset and launching a full scale mutiny, bringing all of her closest co-workers on board. Depression wailed, Energy dropped dramatically and wouldn’t come out from under their desk, and Self-Worth made a very rude gesture at me during my 3 pm coffee break.

When Intimacy made a request to work harder on relationships in an effort to feel more connected I ignored it. I was certain it was Psychosis again, and even though I hadn’t seen them in weeks I thought for sure it was some game of misdirection. Pretty soon Anger snapped after a paper jam and ripped the feeder tray off the unit and Productivity simply stood up and said, “I can’t work in an environment like this, I’m going home.”

I watched chaos erupt from my cubicle and that’s when my phone rang.

“Yes, Department of Consciousness here,” I answered.

“This is HR,” a voice said. “It has come to our attention that you’ve denied a request to make the breakroom more LGBT friendly and I’m afraid Sexuality has come to us to file a complaint.”

“Sexuality filed that comment?!?” I asked astounded, “Are you sure it wasn’t Psychosis?”

“Sarah, Psychosis hasn’t been in in weeks, hasn’t even booted up to work remotely, there hasn’t been a need. I’m afraid the issue at hand is bordering on discrimination at this point so it needs to be addressed immediately. If you can’t take care of it, we’ll find someone who can.” The voice said.

“Wait!” I quickly cried upon realizing I’d never encountered anyone from HR, “Who is this?” But all I heard with a click followed by a dial tone.

*

I’ve gone through years of therapy trying to figure out how to discern which piece of my internal dialogue to listen to, how to pinpoint the difference between when my gut says something to me and when it is mental illness pushing me in a specific direction.

Ultimately I reached the point where I felt the need to scrutinize everything that ran through my head before making any decisions. It didn’t keep me from having manic episodes, or depressive episodes, or psychotic episodes or doing wildly irrational things. All it did was create a backlog of personal issues that built up and began contributing to my anger and depression and paving strange avenues that I’d find myself trying to take to solve those issues when I was psychotic or manic. In some ways it seems as though Psychosis was trying to help me, attempting to take back doors to solve issues I wasn’t solving directly.

That is part of what has made everything so blurry. I was so worked up and emotional about some issues when I was psychotic (or depressed or manic) I couldn’t see how important the same issues were to me when I wasn’t. I simply didn’t feel the same level of intensity about them when I was feeling stable, even though they still mattered.

All this time I’ve considered psychosis to be like a bubble, like I could discard anything that happened within the bubble in which the episode took place and discount any aspect as being useful or informative (though usually a good story later). The psychosis bubbles that arose eclipsed my gut instincts entirely, or at least discounting anything within those bubbles often also meant discounting real and important instincts. Really, the more time I take to understand the issues I’ve been avoiding, the more it seems that my episodes have acted more like a magnet drawn intensely to those same issues rather than provoke or direct me toward new useless ones.

I’m sure all that is confusing, and it is to me too. Even so, this has been a huge revelation for me because it means the eclipse is ending. I’m realizing that there is value in every comment in that comment box, even the ones I considered to be a joke.

I imagined myself in that office, smeared with printer toner and covered in paper cuts climbing on top of my desk and waving my arms.

“Alright! Alright!” I shouted at them. “I’ve been a terrible manager, I can see that now. Ignoring you isn’t helping us get things done and the box,” I kicked the comments box off my desk onto the carpet littered with remnants from the three hole punch and paper clips, “screw the box. The box isn’t working! From now on we’ll have an open door policy and if you need something you can come directly to me. Even you Psychosis,” I added as a fit of giggles came from over one of the speaker phones.

“I’m sorry I went behind your back,” Sexuality said to me as the last of the internal raging died down and we began cleaning up.

“I don’t blame you,” I replied, dumping the old comments box into the trash. “I guess I was so wrapped up in working on communicating to the outside world that I forgot the importance of communication here.”

*

“Um, yes,” I replied to my therapist, blinking for a moment. “I am listening, and I expect I have a hell of a lot to say.”

I’m sure those of you that have been reading a while know that I am a big mood-charting enthusiast and for those of you who haven’t, well, I get a real thrill from any kind of chart or graph in general. Don’t even get me started on those that can convey something as mysterious as the inner workings of living with bipolar disorder… that’s my jam.

I’ve spent a lot of time messing around with different charts and graphs as a result and ultimately I’ve found that there is one type of mood chart in particular that has been very helpful in providing a big-picture look at how my symptoms operate. I call it the “color band mood chart” and it is a way to visualize what types of episodes I have and when they have taken place over a period of time.

I’ve spent some time sharing about this type of charting before (here) but I wanted to revisit the topic because with nearly five years of data now on my chart it becomes very easy to see the comings and goings of my episodes. I live with mood swings that can occur over a long period of time (months) but also swings that can happen several times in a day so this method of charting is really useful for seeing my episode length and severity of symptoms in a single glance.

This type of charting is done on graph paper and the key above denotes how the element of time is displayed in the chart. I have opted to leave out any mood swings taking up less than 3 hours in a day (even though they are often present) to chart the moods that encompass the longest period of time each day. I also limit the mood swings represented in a single block to 3, any more than that and I typically just consider it a “mixed episode” day.

The chart below begins in 2011 and I’ve been compiling data every day (with the exception of a short period in June, 2011) since. Looking back and looking at the chart below I can certainly say that 2011 and 2014 were both pretty hard years for me and both required psychiatric hospitalizations. There have been other times I may have benefitted from hospitalization that I only really recognize by looking back at the chart as well.

If you have been reading the past few months you might remember I had a pretty severe mixed episode in June and part of July and if you look here at the bottom of the chart you can see the dark shapes that represent that period as I fluttered between depressive, mixed, and elevated symptoms.

The information on these two pieces of graph paper have been huge in helping me convey my symptoms to my doctor and also to avoid undergoing treatment that isn’t potentially helpful to my own personal brand of bipolar disorder (as not all types of treatment are useful for all types of bipolar symptoms). I began the chart because I really wanted to find the patterns in how my episodes work, but as you can see there is really much more to my illness than experiencing symptoms at a specific time of year or alternating back and forth between depression and mania specifically. The chart has also been great for seeing how the medications I have tried have effected me and since my symptoms are treatment resistant it has been really important to have this tool to convey the way many medications have triggered (or worsened) episodes for me (like during the past few months) instead of quelled them.

It has been encouraging too to see episodes that were initially big chunks of depression or hypomania become smaller fractured chunks. Even without a medication to stabilize me everything I’ve learned about how to cope with the mood swings themselves has helped me bounce back out of them at times instead of staying locked in. Even though there are times I find there is little I can do to shake my way out of an episode, the smaller daily mood swings are something I’ve learned to cope with somewhat more effectively.

Just something fun to share and maybe some inspiration for those of you living with mood swings (bipolar or unipolar too). Being able to quantify the periods I am having problems has made living with my illness much easier to accept and try to treat.

An article came out this month in the New York Times about an organization called the Hearing Voices Network. The Goal of the Hearing Voices Network is to create support groups where the symptoms of those with psychotic symptoms like hearing voices and having hallucinations are explored to understand where the voices or visions might be coming from and find ways to cope with them mentally and emotionally.

I’m not doing the article or network itself much justice so I would definitely recommend reading about this alternative form of therapy here (at the New York Times Article) or here (at the Hearing Voices Network homepage).

Without going into too much detail I wanted to mention that this topic stood out to me because in a way it reminded me of the type of therapy I have been undergoing with DBT (though certainly not the same thing). The similarity in my mind comes from my experiences the last six months having to address my internal dialogue, generally stop abusing it and being afraid of it, and allow myself to learn where these thoughts and feelings are coming from so that I can cope with them in a healthy way.

Having treatment resistant symptoms of bipolar 1 (which can include psychosis at times) has rendered other types of treatment (like psychiatric medications) useless for me up to this point so my experiences with talk therapy and particularly a group that could help me address those aspects of my illness has been paramount to helping me cope and feel more comfortable in my own skin. I’m excited to see that an exploratory type of alternative therapy like this is being offered to those with severe psychosis because the more types of treatments available mean the more people that will potentially be able to improve.

Of course, both websites mention that this type of therapy isn’t right for everyone, but as someone who has experienced what mental illness is like living as an outlier, having options of things to try before falling into the hopelessness that all else has failed is potentially making a life-saving difference.

I mentioned recently that my psychiatrist has decided to change directions in how we try to treat the mood swings I have emanating from treatment resistant bipolar disorder (type 1).

In the past six years I have actively tried several benzodiazepines (like clonazepam, or lorazepam) , antipsychotics (risperidone, ziprasidone, olanzipine to name a few), mood stabilizers (lamotrigine, oxcarbazepine, gabapentin & more), and antidepressants (sertraline, fluoxetine, bupropion, etc.) but have always experienced either:

worsening symptoms

side effects severe enough to warrant stopping the medications

or tolerable side effects with no response from my symptoms.

The only psychiatric medication I’ve been able to keep taking regularly is Lithium, and while there is some debate on whether it is helping I’ve been taking it for long enough that I am having no side effects so the consensus is usually just to keep taking it.

Starting any of these new medications has typically made my mood swings worse (more frequent and more severe) so it has been a bumpy ride. After my new(est) psychiatrist got a good look at this happening she decided it is probably useless at this point to keep trying in these same classes of drugs I’ve had problems with. Needless to say, this was both a relief (hooray for no more psychiatric drug barrages!) and a little disheartening (alright then, now what?) but after all I’ve been through I’m more than willing to break away from this cycle and try something new.

Like anyone who finds themselves chained to the great lithium beast I have to go get my blood checked every few months to monitor the level of lithium in my blood. During these times I often also undergo other tests to check things like kidney and thyroid functioning.

Apparently my thyroid level doesn’t appear to be outside the range of “normal”, but my doctors have found that for me a tiny change can make a huge difference (as seen with my reactions to most drugs). My psychiatrist also told me that sometimes thyroid medications can be used to treat resistant depression, so our next route is to give liothyronine (cytomel) a shot and see what happens.

I always get a little nervous when I’m given a new drug to try and my doctor asked if I thought it would be better to start it when I am feeling more stable or unstable. That has always been a tricky question for me because if there are significant side effects a drug can easily take me from stability to a place of being unstable, and having less stability I tend to want to take advantage of those times as much as possible. At the same time if side effects occur when I am already very unstable I am less likely to cope in a healthy way so I told her don’t think there is a right answer here.

Ultimately, I’ve had the flu for the last week so as soon as I feel better physically I’ll start the liothyronine regardless of what my mood decides to do. This one comes with all kinds of obnoxious directions (take on an empty stomach at least 30 minutes prior to eating, no antacids for at least four hours after taking it, can’t be taken at the same time as vitamin or mineral supplements -sheesh!) so I need to do some work shifting all of my medications into a system that will allow me to follow those rules.

As scary as it can feel not knowing what will happen, I always feel some element of hope that this time might be different. If I didn’t feel that I’m sure I would have given up ages ago. It might be that I’m just stubborn or absurdly optimistic at times too, but it is easy to gamble when I feel like I don’t have much to lose and there is potential for increadible gain.

Despite how busy summer has been I have found myself doing very few of the things I wanted to do. I’m fully aware that feeling helplessness doesn’t look good on me, so I decided to try a few things outside my comfort zone in an effort to feel more in control of my own life and to pep up a potentially dangerous sense of boredom.

For better or worse, my sense of curiosity has always been able to steer me into the mindset of, “well let’s try _____ and see what happens!” Sometimes the results have been wonderful and sometimes they have been devastating, so when I went to work trying to decide what new thing to try I wanted to be a little conscientious of that fact. Ideally trying something new and maintaining whatever scrap of emotional and mental stability I have is the goal, but knowing that living with treatment resistant symptoms of bipolar disorder means that any little detail could potentially rock my brain-boat is challenging. I have often found myself opting to do nothing at all because doing anything is potentially risky (in terms of creating instability in my mental health) but, tired of doing nothing, I decided the reward was potentially worth the risk.

I have been described as having an “overactive imagination” and more than one therapist has told me that when things are perfectly fine my mind has a tendency to imagine problems that aren’t really there… these days I would consider this description to be something like a cute version of saying, “psychosis”. For a time I thought this might lend itself well to writing fiction, but back in 2007 when I tried my hand at writing a novel I found that I lost track of where the novel ended and reality began. The problems in the story became the problems of real life, and I abruptly vowed never to venture down that path again.

All this time I’ve been writing nonfiction instead, and while I’ve enjoyed writing for this blog the past five years I feel like I am constantly moving toward the point where I wont have anything more to say without being redundant. I’ve been learning a lot about myself and writing in the process (and I don’t expect to stop any time soon) but part of me has wondered if I could write about something else. Anything else, really. I admit there are times where I don’t want to think about my own mental health. I want the freedom to think of other things, of other problems, and for the love of Pete, to talk about something other than myself.

With a little experimentation I found that while writing fiction that takes place in a modern setting (like my writing in 2007) is too close to my own life for me to separate myself from it, writing about situations on other planets or in places I’ve never actually been seems to create enough distance to keep my mind from getting the two confused. It seems that following an odd story down a rabbit hole makes perfect use of my (previously useless) problem-generating brain because stories need conflicts to be interesting.

Writing any fiction at all certainly took me out of my comfort zone, but in the past few weeks I decided to take things one step further and I joined a local writing group. Frankly just getting out of my apartment to meet with them was a huge step and even though I was anxious as heck to make my first appearance I did my best to remind myself that they’re strangers, so who cares if they like me anyway?

It turns out they are all quirky, imaginative, and intelligent individuals and just passively listening to them share about the different projects they are writing was both interesting and encouraging. Within an hour or two I found myself holding conversations with people casually and I left knowing that I wanted to go back again.

Of course, I put it off a little. Since it is a critique group I knew that at some point I would have to share something I had written, and when I’m working on something I’m typically very private about it until the final version is completed. Even though I don’t like sharing something unfinished because of how vulnerable it makes me feel, I have had a lot of questions that I knew would probably be answered if I just powered through my anxiety and shared my work.

So the thing I did this week to step out of my comfort zone was to read something I had written in front of a group of people and listen to their feedback. I had a knot in my stomach all day leading up to the group and every five minutes I could feel myself changing my mind, thinking, “well… I’ll print these read along pages and bring them, but I don’t have to read them.” Then, “well… I will tell the moderator I have something to read, but maybe they wont get to me before the group ends.”

Finally, that night at the group after an hour and a half the moderator asked me, “do you want to go next?”

I knew that if I left without reading I would feel twice as anxious the next time around and I knew I couldn’t handle a double dose of anxiety driven irritable gut another day. I had already gone through 5 or 6 tums and it seemed there was little to do but press on.

I decided to take a leap of faith and even though it was wildly uncomfortable, even though my hands were shaking and my ribs were contracting as I powered through a panic attack while I read, I reached the last page in a triumphant (and slightly dissociative) stupor.

I never used to have problems reading aloud, not when I was in school. I gave so many presentations, so many speeches (even publicly at the state fair) that I never expected to feel so overwhelmed when speaking publicly. I know my anxiety is much worse these days, but I also think that the unfinished nature of my story and the effort I had put into it were huge in informing how nervous I was.

I also know that my Achilles heel is judgement. I’ve never taken criticism particularly well, never felt good about the idea of being examined and torn apart. I feel like I can say that I generally feel good about who I am, but there has always been the fear of judgement present in some form in my life. Fear of God’s judgement as a child, fear around the judgement from my peers in school, fear around critiques in college, and fear around the scrutiny of Social Security and the government as a disabled adult.

By the time I stumbled into the critique portion of the reading I had catastrophized the whole situation so much that it inevitably went much better than I expected. Some of my concerns were confirmed, some new issues were brought to my attention, but for the most part everyone seemed excited about what I had written, which acted as a cork in my odorous anxiety bottle.

My boyfriend, sweet as he is, went to work right away when I got home to remind me that I don’t need to take any of the advice I was given. I don’t need to change anything I wrote if I don’t want to. I know he has continuously witnessed the way other people’s opinions have acted like quicksand for me in the past. The defiantly obsessive portion of my brain loves to latch on to those statements without letting go, and I immediately found myself wrestling with them as they echoed (ironically) in my mind, “redundant, redundant, redundant…”

The difference now comes from the knowledge that has come from my DBT group. I know that when I’m closed in with the garbled echoes of disappointment or disapproval or judgement I can open the windows in my brain-house and let that stuff escape. I don’t have to be hosting the equivalent of a mental dinner party six years from now and set an extra place setting for “redundant” because it’ll be long gone. That’s the hope, anyway.

Having said that, I don’t know if I will read my writing aloud again any time soon. I need time to practice letting go of these comments, time to sort them out of the “terribly important, don’t stop thinking about this,” pile into the, “backlog” bin. If I can manage it without much incident I expect to have another go, because having the opportunity to practice letting go of, “this sentence is redundant,” is infinitely easier to me than having to let go of considerably more cruel and pointless scrutiny. Anything I can do to help myself learn and grow is good, but anything that also helps me learn to be less reactive and less prone to destabilization is a serious win.

Of all the things I’ve read and researched and talked about in terms of coping with mental illness I don’t think I’ve ever quite been prepared for the notion of coping with what comes next. Having poured my full attention (alright, we’ll say about 75%) into how to cope with living with treatment resistant bipolar disorder I’ve found which strategies have been helpful for me(DBT, ongoing therapy, group therapy, limited drugs and herbal remedies) and which haven’t (CBT, psychiatric medications -though my doctor is now trying a new approach which I’ll discuss later on, and the old fashioned I’m-going-to-stuff-all-my-feelings-down-and-ignore-them trick, to name a few).

In the time I have spent with the majority of my focus on mental health related topics (about 5-6 years) I often found myself growing in helpful ways, but then sort of falling behind every time I had a major episode. I would say that in that time I very rarely felt like I was able to get ahead of the curve when it came to my mood swings or anxiety and even when I was able to rebuild my own sense of self and self-worth from the ashes of a major depressive or psychotic funk my treatment resistant symptoms had a habit of pulling the rug out from under me all over again, requiring me to start at square one.

While I don’t like the idea of calling myself self-absorbed or self-involved, living this way (without continuously going full ass-over-tea-kettle) has meant spending a LOT of time crawling my way out of the dark corners of my mind with nothing but a spoon and a flashlight, or untangling myself from the intrusive thoughts that pop up, or needing to ask people to help me by doing things that seem strange to them, to say the least, in order to keep from constantly triggering me. I’m fully aware that this sort of living probably doesn’t look good to those on the outside looking in, and having to spend so much time focusing on my own issues has meant having a hard time with personal relationships (wait, when is your birthday again?) and generally seeming like a distant asshole.

That life, though, that sort of living and coping with the constant need to pay attention to every little detail inside myself in order to keep from being overwhelmed by it, that is honestly where I have built a (we’ll say -though not exactly) comfortable existence for many years. This is the world I know, the world that is 75% me dealing with my own mental health issues and having 25% of my time and energy and interest left over for things like relationships with other people, doing housework, leaving my apartment, having a job, and being creative. Showering. Playing with my dog. Discerning which banana has reached peak ripeness. Important things. If you consider it, 25% of my time isn’t a lot to try and do all of those things and I’ve had to cut out a lot of them, especially since that 25% has encompassed when I’m feeling at my best. In a full blown episode I might have only 5% of my brain available for all of those things, so obviously taking advantage of every resource available to me to try and increase that number has been my main priority.

Alright, so if that is a general approximation of how things have been the past 5 years, what does it look like when the numbers begin to change?

Even without a medication to help stabilize me my doctors and I are beginning to realize that I am more stable when not subject to a constant barrage of new medications to try. My system is simply too sensitive to keep playing medication wheel of fortune on repeat, but given the proper amount of down time to sweat out all those side effects I can function better without them (go figure). It isn’t the difference between being totally stable and in crisis, more like 25%-30% stable or in crisis. I’m not suddenly a rocket scientist or anything, but every little bit helps.

After that important discovery, DBT (dialectical behavioral therapy) coming into my life has made a huge impact. Again, not cured or totally stabilized by any means but I’m learning to cope more effectively. Instead of having to crawl through the dark recesses of my mind with a flashlight and a spoon it’s like I’m learning where all of the light switches are. When I’m getting tangled in obsessive or anxious thoughts I’m learning that the less I struggle, the less hold they seem to keep on me (like that plant in Harry Potter, oh, you know the one). With all of the things I am learning, I am definitely making changes in my life that are allowing me to go beyond having that limited 25% external focus.

But here’s the kicker. I’ve found that working on coping with my mental health issues isn’t enough. No, there is actually a subplot here where I am rapidly discovering that having time to focus more on the world around me, and particularly the people in that world, has meant having to learn a whole new set of skills to cope with the clarity that my newfound perception is affording me!

Being in a position to improve my own mental health has made it difficult for me to watch the people in my life who may not be coping with their own situations very well… and I may not have noticed how frequently many of them were struggling until I was able to look away from my own problems enough to see it. In a sense, I’m having to find ways of coping with the realizations and discoveries brought on by my initial coping and it feels like the most bizarre twist life has thrown me in a while (and I’ve had psychotic episodes so that’s really saying something).

Somehow… being more self aware has led to me needing to spend less time being self aware, and all that extra focus I’ve been able to put on the people around me because of it has made me see things I really didn’t notice before. The most maddening part of all of it is discovering that most people aren’t even aware these issues exist, or are quick to deny them, or cope in ways I know are wildly self deprecating and dangerous.

In that way, the coping that has been afforded me through DBT really started out as all hearts and stars (and horseshoes, clovers and blue moons… pots of gold and rainbows, and the red balloons!) but I’ve concluded that with the knowledge I’ve gained I inadvertently stumbled upon a double edged sword. I never asked to be able to use this strange, newfound mental health x-ray vision on others… I only wanted to use it on myself! Damn.

I’m doing the only thing I can do (or at least, what I can do and keep the relationships) and try to practice being nonjudgmental and accepting and all of that exceptionally difficult stuff, but there seems to be a natural shuffle where many aspects of my life (including my different relationships) are currently up for reevaluation because I’m seeing everything in a whole new light. I want a healthy life that will help reinforce the positive strategies I have been learning because without the aid of medication, they’re one of the only tools I’ve really got. At the same time we’re all human and I can respect the fact that no matter where I go or who I meet, the vulnerable flaws of humanity are not escapable.

As always, I’m working to find the balance between these things, even if the ride has been wholly unexpected.